Which antibiotics are used to treat pediatric urinary tract infection (UTI) and how are they used?

Updated: Mar 19, 2019
  • Author: Donna J Fisher, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Treat febrile UTI as pyelonephritis, and consider parenteral antibiotics and hospital admission for these patients.

Antibiotics for parenteral treatment are as follows:

  • Ceftriaxone

  • Cefotaxime

  • Ampicillin

  • Gentamicin

Patients aged 2 months to 2 years with a first febrile UTI

If clinical findings indicate that immediate antibiotic therapy is indicated, a urine specimen for urinalysis and culture should be obtained before treatment is started. Common choices for empiric oral treatment are as follows:

  • A second- or third-generation cephalosporin

  • Amoxicillin/clavulanate, or sulfamethoxazole-trimethoprim (SMZ-TMP)

Children with cystitis

  • Antibiotic therapy is started on the basis of clinical history and urinalysis results before the diagnosis is documented

  • A 4-day course of an oral antibiotic agent is recommended for the treatment of cystitis

  • Nitrofurantoin can be given for 7 days or for 3 days after obtaining sterile urine

  • If the clinical response is not satisfactory after 2-3 days, alter therapy on the basis of antibiotic susceptibility

  • Symptomatic relief for dysuria consists of increasing fluid intake (to enhance urine dilution and output), acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs)

  • If voiding symptoms are severe and persistent, add phenazopyridine hydrochloride (Pyridium) for a maximum of 48 hours

See Treatment and Medication for more detail.


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